ISSUE: How should we value HRQoL of children? OVERVIEW: The estimation of QALYs for use in HTA relies on utilities for health related quality of life (HRQoL). The methods for eliciting utilities for health states experienced by adults are well established. However, the valuation of children’s health states poses additional challenges, and raises a number of complex methodological and normative issues. For example, while by convention stated preferences are usually elicited from the (adult) general public, the valuation of children’s health states raises the question of what perspective adults should adopt in imagining and valuing children’s HRQoL – and what difference this might make to the values. Might children’s preferences differ from those of adults – if so, should that be considered in HTA? We observe that adults are less willing to trade off life years for children – leading to higher TTO values for children'shealth states. What are the implications of that for HTA? What are the implications for the choice of methods to use in eliciting preferences for children’s HRQoL? If we use different methods to value children and adult HRQoL, does that cause a consistency issue for cost effectiveness models that include both childhood and adulthood states? Addressing these issues is critical to ensuring a robust and defensible basis for HTA of technologies addressing childhood illness. In this issues panel, we begin by outlining the empirical and normative issues associated with valuing children’s HRQoL. We summarise the evidence available on each issue, with particular reference (but not limited to) stated preference studies for the EQ-5D-Y and CHU-9D. Gaps in methods and evidence are highlighted. We consider current guidance and practice regarding utilities for children’s HRQoL in HTA, and consider what early advice should be given to companies asking about the measurement and valuation of children's HRQoL.